Individual provider Active NPI

Debra Susan Lewis, L.M.T

  • Massage Therapist
  • Rochester, NY
National Provider Identifier
1063682706
Registry record updated Apr 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
007641 Issued in NY
Practice address
2425 Clover St
Rochester, NY 14618-4517
Phone
(585) 734-3267
NPI assigned
Mar 10, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 19, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X 007641 NY Primary

Addresses

Primary practice location

2425 Clover St
Rochester, NY 14618-4517

Mailing address

2425 Clover St
Rochester, NY 14618-4517
Phone (585) 734-3267

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
007641NYMDOptometrist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1205107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334793600000",
    "number": "1063682706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2425 CLOVER ST",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146184517",
            "telephone_number": "585-734-3267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2425 CLOVER ST",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146184517",
            "telephone_number": "585-734-3267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "DEBRA",
        "middle_name": "SUSAN",
        "credential": "L.M.T",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-03-10",
        "last_updated": "2012-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "NY",
            "license": "007641",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.